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Full text of "Medical Jurisprudence And Toxicology"

748                                              MEDICAL JURISPRUDENCE

accidentally mixed with caraway, anise and dill seeds. Accidental poisoning
may also occur from smelling coniine or from inhaling the vapours given off
from "boiling water containing a preparation of conium.

The ancient Greeks were familiar with the toxic properties of conium
maculatum, and used its juice or an infusion of the leaves as a State-poison.
Socrates was put to death by drinking the infusion.

Coniine is rapidly eliminated in the urine so that its action passes off
very soon, if death does not occur.

CURARE (CURARA, WOORARA, OURARI, URARI OR WOORALI)

This is a blackish-brown gummy resinoid extract obtained from the bark and wood
of species strychnos toxifera (N.O. Loganiacese), Cocculus toxiferus ^ (N,0, Menisper-
maceae) and other plants which occur in South America, It has a bitter taste and is
nearly soluble in water. The non-official dose of curare is 1/20 to \ grain subcutaneously.

Curare contains an active principle, curarine or curarina, which is the most power-
ful poison and occurs as a yellowish brown powder or in deliquescent prisms, with an
intensely bitter taste. It is soluble in water and alcohol. Curare also contains curine
and d-tubocurarine,

Symptoms.—Curare is extremely poisonous, and exerts its toxic properties, when
injected into the blood stream by means of a hypodermic syringe or through a wound.
When swallowed, it is supposed to be almost inert like snake-venom, provided there is
no abraded surface in the mouth or throsit.

Curare acts on the motor end-plates causing paralysis of the voluntary muscles,
and causes,death by paralysis of respiration and anoxia.

Fatal Dose.—One half to a grain of curare would probably prove fatal,
Fatal Period.—An hour or two.

Treatment—This consists in the use of stimulants, such as strychnine hypodermically
and positive pressure artificial respiration with oxygen, if necessary. If the poison is
applied to a wound, a ligature should be applied at once at its proximal end, and the
poison should be sucked out from the wound provided there are no abrasions in the
mouth or throat or the poison should be neutralized by washing the wound with a solu-
tion of potassium permanganate. Prostigmin and Substance 36 (methyl-phenyl-carbaroic
ester of S-oxyphenyl-iximettLyl-ammonium^methyl sulphate) which is an analogue of
eserine and closely related to prostigmin are considered to possess antagonistic properties
to curare.

Post-mortem Appearances.—Signs of asphyxia may be found.

Tests.—1. Sulphuric acid and potassium bichromate produce first a blue cojour,
then violet and lastly cherry-red. Strychnine undergoes the same reaction, but takes
a longer time.

2. Sulphuric acid imparts a red colour to curarine and nitric acid gives a purple
colour.

Medico-Legal Points,—Curare is smeared on the darts and arrows which are used
by South American Indians in hunting and warfare. Curare has recently come into use
as an adjunct to general anesthesia, especially in cases of abdominal operations, as it
produces muscular relaxation, also used to prevent injury in electro-shock therapy for
mental diseases. Tubocurarine chloride, which is less poisonous, is used generally for
this purpose in pkce of curare.

It is reported that in the year 1917 a plot was laid to poison Mr. Lloyd George, late
Prime Minister of England, with curarine.

Curare is rapidly excreted unchanged by the kidneys.